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AGENCY CUSTOMER ID: RINCCON-01 <br />LOC #: 1 -- <br />PRIETOP <br />A � a <br />ADDITIONAL REMARKS SCHEDULE <br />Page 1 of 1 <br />AGENCY <br />Legends Environmental Ins. Services <br />License # OE67768 <br />NAMED INSURED �W`^ <br />Rincon Consultants, Inc. <br />210 N Ashwood Ave <br />Ventura, CA 93033 <br />POLICY NUMBER <br />SEE PAGE 1 <br />CARRIER <br />SEE PAGE 1 <br />NAIC CODE <br />SEE P i <br />EFFECT VE DATE; S E P E 1 _ <br />ADDITIONAL REMARKS <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: ACORD 25 FORM TITLE: Certificate of LlaILI itylnsurance <br />Description of Operations/Locations/Vehicles: <br />General Liability, Auto Liability and Workers Compensation as required by written contract, per Endorsement EN0147-1111, <br />HA99160312 & WC000313. Excess policy follows General Liability, Auto Liability and Employers Liability form. <br />ACORD 101 (2008/01) @ 2008 ACORD CORPORATION. All rights reserved <br />The ACORD name and logo are registered marks of ACORD <br />